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Putting Kiruddu hospital deaths into context

As I entered Kiruddu hospital in Salaama, Makindye division at around 11am, I found one Nampewo at the emergency ward mourning the death of her husband.

“Wowee….Wowee… my husband has gone too, yet I had just lost a baby and my father, all in this hospital, this year! The moment they injected him, he breathed his last. But I know his death is connected to witchcraft,” she wailed.

Nampewo said they have been living with HIV/Aids and have been taking their drugs, and is adamant her husband’s death cannot be linked to Aids; rather, to witchcraft.

“We have also spent much time in the emergency ward, without doctors attending to us yet my patient was in critical condition,” she said.

Perez Magomu is another I found receiving treatment in the emergency ward. Magomu told The Observer that the death rate at Kiruddu hospital is very high since, so often, one sees people crying and vehicles taking away dead bodies.

“You can come here when you are not so weak, but the increased rate at which people cry after losing their loved one, traumatizes you and worsens your sickness,” he said.

Esther Wamala agrees with this; last year, she went to Kiruddu to see a heart specialist and sat in the waiting room.

“When I arrived, I just wanted a checkup; I was not feeling sick. But the wait is too long and the scenes too depressing. There was heavy traffic of workers clearing wards of dead bodies. I had to leave without seeing the specialist, because I had started feeling gravely ill!” she recently said.

WHY THE DOMINANT PICTURE OF DEATH?

Sarah Namutebi, a patient’s attendant I found washing clothes near the hospital mortuary, said, “Kiruddu is so scary.”

“We were peeping into the mortuary as we were washing. Pathologists were cutting bodies as if they were slaughtering goats,” she said.

Magomu believes the increased deaths at Kiruddu hospital are due to the few consultants and senior doctors, yet most patients referred there have complicated diseases.

“Most consultants and senior doctors come once or twice a week only to check on their patients referred from their own clinics,” Magomu said.

Patients waiting for doctors at Kiruddu hospital

Namaganda, also a patient attendant, said most of the doctors on duty are interns that work half day. Very few doctors work at night, which increases deaths in the night.

“Coffins, food and airtime are the most selling businesses at Kiruddu hospital. Every time you see people crying while others call relatives to buy coffins and come pick the bodies,” she added.

But Wamala had a different view.

“The doctor friend who had referred me to Kiruddu told me when I complained later, that the hospital is like Mulago national referral hospital’s Wards 4A, 4B and 4C. That the fourth floor in Mulago had most of the infectious disease cases, which also come with rampant deaths,” she said.

“She said when Mulago was closed for renovation, this fourth floor’s services and patients were part of what was transferred to Kiruddu; so, the deaths are inevitable.”

Mulago last year transferred patients and services to Old Mulago hospital, Kiruddu and Kawempe general hospitals, to give way to much-need renovation work.

A medical officer at Kiruddu’s emergency ward told The Observer some people fear their patients could die at home and not get death certificates for estate administration; so, when they see patients on the brink of death, they rush them to the hospital to die from there and get certificates.

But according to Magomu, Kiruddu also lacks drugs for complicated diseases including kidney disease, liver complications, diabetes, HIV/Aids and others.

“Sometimes doctors prescribe expensive drugs which the patients cannot manage to buy daily and they end up dying,” he said.

One David who had come to pick his HIV/Aids drugs said he had received just one packet for a month, yet they had been giving him three packets for three weeks.

Hospital defense

According to hospital director Dr Charles Kabugo, also a consultant physician, most patients that die at Kiruddu have been referred there by private hospitals around Kampala after doctors realising that they cannot save the patient’s life yet they have extorted a lot of money from them.

“According to our records, out of 600 inpatients and outpatients registered at Kiruddu hospital daily, only four to five patients die within 24 hours. Is that a big number? Most patients die on arrival before even getting admitted,” he said.

That is 0.8 per cent of Kiruddu’s daily registered patients. But understandably for a patient witnessing from the waiting room, even three bodies in a few hours can be three too many.

Store keeper shows some of the drugs at the hospital

Kabugo said most patients die within two to three hours of admission since they are referred in advanced stages with complicated cases and the doctors cannot do much to save them.

“Most of the private hospitals fear deaths on their hands and that is why they refer patients to Kiruddu, the national referral hospital, and they keep a clean record with very few deaths,” he said.

Kabugo blamed Kiruddu residents for alarming the public about the increased deaths at the hospital, since they are ignorant about the hospital’s operations.

“Kiruddu residents have been used to a small KCCA health centre which treats only malaria and flu. But when it turned into a national referral hospital where all complicated diseases are referred and the patients rushed there all the time are in critical condition, they think all [patients] are dying and alarm the public,” he said.

Kabugo refuted allegations that intern doctors attend to patients alone.

“Intern doctors can’t attend to patients without supervision from consultants and senior doctors,” he said.

Kabugo said he has a team of more than 50 specialists who inspect patients everyday within different shifts, since all the consultants cannot be on duty all the time.

“The doctors work day and night and the hospital which was designed to have 170 inpatients, now admits about 250 due to overwhelming numbers,” Kabugo said.

He said other patients die because they come with complications such as needed kidney transplants, which are not done at Kiruddu. Since they are referred in late stages, the doctors cannot help them.

Kabugo said people also die due to poor lifestyles such as not going to hospitals for general medical check-ups, turning up late for treatment and eating junk food without physical exercises.

“The most diseases killing people at Kiruddu hospital are non-communicable diseases (NCDs), especially cancer, hypertension and diabetes,” he said.

The hospital spokesperson, Nelson Obote, said emergency drugs and antibiotics are available but others for complicated illnesses are out of stock and they prescribe for patients to buy due to budget shortfalls in the ministry of health.

“As Kiruddu hospital, we don’t buy drugs. We request them from National Medical Stores (NMS). But as per now, our budget for this financial year is over due to the many patients we get daily. And this has led to a decrease in drugs,” he said, adding that NMS is waiting for next year’s budget to supply them more drugs.

The Kiruddu team wants the public to understand that the problem is not with the hospital; it is about people getting referred there in late stages after wasting time in clinics and witchdoctors’ shrines.

Services at Kiruddu

Kabugo said the eight-floor complex offers dialysis services on the eighth floor for cases of kidney failure, and about 40 people are worked on daily.

The seventh floor is the private wing, for inpatients with different diseases. The sixth and fifth floors hold general wards that admit between 200 and 250 patients, yet the whole hospital was designed to admit about 170 patients, according to Kabugo.

“On this floor, we find patients with liver disease, hepatitis B, sickle cell anaemia, stroke, hypertension, diabetes, HIV/Aids, heart disease, cancer, intestinal problems and others,” he said.

The fourth floor is for burns and plastic surgery.  It is the only floor in the hospital with an operation theatre and Kabugo said the rest of the theatres will fully function after the completion of Mulago.

“When we get patients who need operations, we refer them to Mulago hospital since we also don’t have enough surgeons,” Obote said. The Old Mulago complex is still open for business.

The third floor is for private outpatients who come for general medical check-up and consultation. The second floor is for diagnostics, laboratories and scans. 

The first floor is the assessment center where people first register their cases before they are connected to doctors and consultants to check and prescribe drugs for them.

On this floor, there are different specialized clinics such as dental, skin, cardiology, HIV/Aids, diabetes and others. The ground floor is for emergencies and admission of patients.

According to Kabugo, death is beyond anyone’s control at times. It occurs anywhere, even when people go to America, Europe, India and South Africa; “when it is their day, they die”.

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Comments   

+7 #1 Mark Mugisha 2017-04-14 11:02
This hospital director is a disaster!

It is funny for a doctor to say 4-5 people die here daily and the ask "is that a big number".

Am so surprised a consultant asks such a stupid question. Nobody is supposed to die.

4-5 is infact a very big number and the responsible staff should infact be held responsible! This is irresponsibiloty of the highest order. I wonder what the government does for us the poor!
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+4 #2 Ensi eno! 2017-04-18 16:05
"According to our records, out of 600 inpatients and outpatients registered at Kiruddu hospital daily, only four to five patients die within 24 hours. Is that a big number?" Chutzpah!!! This idiot must be mad! What if those 5 include his father, mother, wife and his 2 lovely children? Will it still be a little number?

When you go to public health facilities, you come to realize how useless human life can be to some people, these guys have no empathy at all.
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+3 #3 Lakwena 2017-04-20 08:20
In other words, in Uganda you fall sick/ill at your own risk.
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+2 #4 ogwetta santa pentec 2017-04-22 11:59
Dr. Kabugo should apologize for such careless talk. it shows lack of empathy for the dead, the sick OR DEAD to him are just a STATISTIC!
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+1 #5 Samson 2017-04-25 19:22
The hospital director isn't satisfied with the small number of patients dying. He wishes the number was 100 every 24 hours.

No one should complain till the number rises to 100. Everyone should shut up in the meantime.

This means there is no emergency yet. Only 5 people dying daily? You are mad if you are shocked by such a small number.

Is this fool a doctor that took the oath to save lives at all costs?

This buffoon shouldn't be anywhere near a medical facility.
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+1 #6 joab 2017-05-09 23:26
fear the dead,we might be commenting from the most emotional and ignorant point of view.

We should be asking Who are those dying? are these conditions that can be managed here in Uganda?

Are they the very elderly where they would pass on even in the best settings? I have seen doctors do a lot but some times our lenses are too myopic to see the way they see.

I dont support the idea that some body should dye but i am alive to the fact that as long as we are living, at some point we shal die.

That could be the point. Stop attacking them, but ask for real answers
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0 #7 Nsubuga Peter 2017-05-12 10:17
The doctor only lacked the language for public.

He is a scientist, speaking facts and they talk and analyze figures. The reporter is to blame.

Should have reported interview from the PRO of the hospital; they are trained for that. It was good reporter didn't find pathologists.
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0 #8 Nsubuga Peter 2017-05-12 13:19
Before we throw insults, let's understand the director director.

He is a scientist. They deal, analyze, explain and understand figures. He may be lacking language for the public.

But still need no harassment. He is not the PRO. The probem is the news reporter.

She went to the wrong person or failed to transcribe the technical language for public consumption.

But she could have deliberately let out just to have a story that would sell. Otherwise all that talk about the mortuary is just sensentional.

Do you expect dead bodies to be handled as its done to live ones in the theatre? Its good the reporter did nor interview the pathologist.
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